Post on 18-Jan-2021
Accreditation of your office-based
vascular lab: A must
Jose I. Almeida, MD, FACS, RPVI, RVTDirector, Miami Vein Center
Voluntary Associate Professor of Surgery
University of Miami School of Medicine
Faculty DisclosureJose I. Almeida, MD, FACS, RPVI, RVT
1. Research grant supportAngioDynamics, Covidien, Sapheon, Vascular Insights
2. Managing PartnerVascular Device Partners, LLC
Why Become Accredited?
Process clearly organizes Vascular Laboratory
testing and improves quality of patient care.
Increase physician & patient referrals.
Will be required for reimbursement in the future…?
Accrediting Organizations
Organization Year
Founded
Accredited
Organizations
Joint Commission on
Accreditation of Healthcare
Organization
(JACHO)
1951 15,000
Accreditation Association for
Ambulatory Health Care
(AAAHC)1979 3,600
Intersocietal Commission
for the Accreditation of
Vascular Laboratories
(ICAVL)
1990
1229
(913 Venous)
Florida: 86
28 (33%) Hospital Based
Outpatient Surgery Safety Committee &
Florida Board of Medicine
Basic standards for Level I surgical procedures.
Rules for Level II and III anesthesia are more stringent.
All offices using IV sedation or general anesthesia
must be accredited by the JCAHO, AAAASF, AAAHC,
and adverse incidents must be reported to the Medical
Board of Florida.
Risk management program with detailed logs.
Balkrishnan R. Dermatol. Surg. 2003
AAAHC
ICAVL
$200 Application Kit
$1,000 Base Fee
$500 Supplies
$300 per Area of Accreditation –
Arterial1, Venous2, Extracranial3, Intracranial4,
Visceral5, and Screening6.
Contractor Name:
First Coast Service Options, Inc.
LCD Title:
Non-Invasive Evaluation of Extremity Vein
Contractor Number: 09101 & 09102Contractor Type:
Training Requirements
The accuracy of non-invasive vascular diagnostic studies depends on the
knowledge, skill and experience of the technologist and the physician
performing the interpretation of the study.
Consequently, the technologist and the physician must maintain proof of
training and experience.
All non-invasive vascular diagnostic studies must be:
(1) performed by a qualified physician, or
(2) performed under the general supervision of a qualified
physician by a technologist credentialed in vascular
technology, and/or
(3) performed in a laboratory accredited in vascular
technology.
A qualified physician for this service is defined as follows:
Training and expertise must have been acquired within
the framework of an accredited residency and/or fellowship
program in the applicable specialty/subspecialty or must
reflect extensive continued medical education (CME)
activities.
If these skills acquired by CME, the courses must be
comprehensive, offered or sponsored or endorsed by an
academic institution in the United States and/or by the
applicable specialty/subspecialty society in the United
States, and designated by the American Medical
Association (AMA) as Category 1 Credit.
Examples of certification in vascular technology for non-
physician personnel include:
Registered Vascular Technologist (RVT) credential
Registered Vascular Specialist (RVS) credential
These credentials must be provided by nationally
recognized credentialing organizations such as:
The American Registry of Diagnostic Medical
Sonographers (ARDMS) which provides RDMS and RVT
credentials
The Cardiovascular Credentialing International (CCI)
which provides RVS credential
Appropriate nationally recognized laboratory accreditation
bodies include:
Intersocietal Commission for the Accreditation of
Vascular Laboratories (ICAVL)
American College of Radiology (ACR)
However, if the facility has a documented process for grand-fathering
experienced technicians who have performed the services referenced in this
LCD (a process addressing years of service and experience with number of
supervised cases), this documentation should be available to Medicare upon
request; otherwise the provider must have documentation available to Medicare
upon request which indicates that the technician meets the credentialing
requirements as stated above or is in the process of obtaining this
credentialing.
Administrative Part
Practice Demographics
Practice History
Annual Volume
Staff (Medical Director, Technical Director, Technologists, and Medical Staff)
Credentials
Policies
QA
Instrumentation
Venous Part
Indications
Technical Protocols
Diagnostic Criteria
Correlation Analysis (Vascular Laboratory vs. Various Modalities)
Logs
Example Cases
STANDARD – Medical Director
1. must be designated for the facility.
Medical Director qualifications:
Supervises the entire operation; may delegate specific duties to
appropriate staff
Maintaining and assuring compliance to the standards as outlined
in this document
Comment: If the Medical Director is off site, he/she must have a
physical presence in the lab to participate in regular QA
meetings, case study review conferences, personnel interviews
and other laboratory operations.
STANDARD – Technical Director
1.must be designated for the facility.
2.generally a full-time position.
If the Technical Director is not onsite full time,
he/she must work a minimum of 20% of normal
business hours each month AND
An appropriately credentialed technologist must be
appointed in the Technical Director’s absence and
report to the Technical Director.
Comment: The Medical Director or a member of
the medical staff must satisfy the qualifications of
the Technical Director to serve in that capacity.
Jose I. Almeida, MD, FACS, RPVI, RVT
THE ICAVL DOES:
Attempt to stay abreast of payment
policies as a service to the vascular
community.
Communicate information to
vascular laboratories about
payment policies (through the
ICAVL website, newsletter articles)
THE ICAVL DOES NOT:
Establish rules or regulations for
the insurance carriers.
Thank you!
Conclusion:
Credentials, credentials,
credentials